Case 616 Anomalous Origin of the Left Anterior Descending Coronary Artery from the Pulmonary Trunk with Origin of the Right and Left Circumflex Coronary Arteries from the Aorta

Abstract

Origin of both right and left main (LM) coronary arteries from the pulmonary trunk (PT) rarely allows survival for more than 2 weeks after birth. Origin of the LM from the PT with origin of the right coronary artery from the aorta allows longer survival, but usually (80%) for no more than 1 year after birth. Origin of the right coronary artery from the PT and the LM from the aorta, in contrast, allows survival into adulthood and maybe a normal life span. Because the LM is equivalent to 2 major coronary arteries, whenever the LM arises from the PT, whether in association with the right artery or when isolated, survival is short. However, when 1 major branch of the LM arises from the PT and both the right and the other major LM branch arises from the aorta, the survival rate should be similar to that in patients in whom the right coronary artery arises from the PT and the LM from the aorta. In this report we describe a man in whom the left anterior descending coronary artery (LAD) arose from the PT and the right and left circumflex (LC) coronary arteries from the aorta.